Laserfiche WebLink
PUBLIC City of'Paris EMS <br />Medicare Ground Ambulance Dala Colleetion Services <br />ATTACHMENT A <br />CONTRACTED SERVICES <br />Ground Ambulance Data Collection System <br />A. PROVIDER provided at least one Medicare ground ambulance transport in the calendar year of <br />2017, is enrolled to receive Medicare payments, and received notification from CMS of its re- <br />quired participation in the Medicare Ground Ambulance Data Collection Survey (the "Survey"). <br />PROVIDER must comply with both U.S. Department of Health and Human Services under the <br />Health Insurance Portability and Accountability Act of 1996 (HIPAA) and the Health Information <br />Technology for Economic and Clinical Health (HITECH) Act and as such, CONTRACTOR shall <br />comply. <br />B. This Ground Ambulance Data Collection Survey requests individual providers to submit data to <br />CMS that relates to organizational characteristics, utilization, costs and revenue. The data may be <br />used by CMS to evaluate the adequacy of Medicare payment rates for ground ambulance services, <br />to inform future Medicare rate changes, and possible payment system reforms. <br />C. CONTRACTOR shall be familiar with the Medicare Ground Ambulance Data Collection Survey <br />and all the rules, regulations and requirements associated with the Survey. <br />D. CONTRACTOR shall have the knowledge, skills, and ability to fully complete the required data <br />survey to the Center of Medicaid and Medicare Services (CMS) within the time frame prescribed <br />by CMS. <br />E. CONTRACTOR shall have knowledge and experience in the completion of all 13 Sections of the <br />"Instrument" Survey. <br />F. PROVIDER will provide CONTRACTOR with all of the required data needed to complete the 13 <br />Sections; however, CONTRACTOR is responsible for accurate completion of the 13 Section "In- <br />strument" Survey. <br />G. CONTRACTOR shall be able to accept data from PROVIDER in electronic submission form via a <br />secure connection in accordance with the Health Insurance Portability and Accountability Act <br />(HIPAA). <br />H. CONTRACTOR shall keep PROVIDER informed of all updates relating to the Survey. <br />CONTRACTOR will prepare and audit the completed Survey and its supporting documentation in <br />accordance with the Medicare principles of reimbursement that include but are not limited to 2 <br />CFR 200 Uniform Administrative Requirements, Cost Principles, and Audit Requirements for <br />Federal Awards, and other relevant documents which provide regulatory guidance on allowable <br />costs and provider charges. <br />Page 10 <br />